Three Considerations for the Implementation of Environmentally Sustainable Healthcare Systems

By: Esther-Joelle Asare

The global climate crisis presents a need for urgent responses from institutions in all sectors. When regarding both planetary health and human health, there is a tendency to believe that the two exist in entirely different realms. In reality, however, the two are inextricably linked, prompting the need for sustainable healthcare – a system which “improves, maintains or restores health, while minimizing negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and well-being of current and future generations” (WHO Regional Office for Europe, 2017). This introduces a new challenge: adopting ecological policies such that these initiatives do not detract from, but rather, reinforce core health system functions. In this endeavour, healthcare systems must engage transdisciplinary perspectives to address the needs of their communities in light of the constantly-changing environmental conditions.

Why do we need environmentally sustainable healthcare systems?

1) Healthcare systems are key contributors to climate change.

Confronting the climate crisis in this context begins with the recognition that healthcare systems serve as key stakeholders in environmental decline. Given that their day-to-day operations come at a consequential cost to the environment – effectively identifying them as major producers of emissions and waste – healthcare systems can no longer separate themselves from the demands of environmental sustainability. According to the Health Care’s Climate Footprint report, the health sector’s climate footprint accounts for an astounding 4.4% of global net emissions, which is equivalent to 2 gigatons of carbon dioxide (Health Care Without Harm, 2019). As these numbers continue to rise, the tangible, long-lasting impact of health sector operations can no longer be ignored. The health sector must demonstrate a commitment to taking a more environmentally-conscious stance in reframing their activities while maintaining their highest standard of patient care.

2) Human health and environmental sustainability are not mutually exclusive.

There is a direct relationship between planetary health and human health; a decrease in planetary health will, undoubtedly, lead to a corresponding decline in human health. As outlined in Educating for planetary health and environmentally sustainable health care: Responding with urgency, “the emergence of novel respiratory and cardiac problems due to air pollution, as well as poverty, starvation, the resurgence of previously managed infectious diseases, mass dispossession of populations, and increasing cancers due to carcinogenic pollutants will begin to rise at alarming rates, challenging the health sector’s ability and capacity to deliver services at critical times” (McLean et al, 2020). Regardless of whether or not healthcare systems begin to address their role in the climate crisis, healthcare workers will be forced to deal with the social and health consequences of a declining environment. Without restructuring the system to promote effective waste management and decreased emissions, the health sector will be completely overwhelmed with largely preventable diseases at an alarming rate, thus compromising the ability to meet the health needs of the future.

3) Environmental sustainability provides a competitive economic advantage.

Restructuring routine procedures and operations to engage sustainability practices often generate added value for organizations’ core activities (WHO Regional Office for Europe, 2017). The Environmental Sustainability in Hospitals: The Value of Efficiency report lists several opportunities for economically-advantageous sustainable practices including:

Switching disposable sharps containers to reusable containers. The change prevents around 40,000 pounds of waste generation annually, saving hospitals about 5 percent of their sharps container costs.

Installing energy-efficient lighting. Lighting accounts for over 10 percent of hospital energy consumption. For an average 600-bed hospital with 300 exit signs, this project would cost around $17,100 and save $14,755 a year.

Upgrading lavatory faucets to low-flow fixtures and replacing shower heads and toilets. The Huntington Veterans Affairs Medical Center implemented a faucet/shower head replacement program conserving more than 1.5 million gallons of water per year. The program saved the hospital $12,900 in water and sewer costs annually, plus an additional $7,200 in energy savings by reducing the amount of hot water used (American Hospital Association, 2014).

By implementing climate-friendly infrastructure in relatively small but impactful ways, healthcare systems can see a significant return on their investments. Ultimately, lower operational costs will yield more resources for patient care.

Environmental sustainability is a global effort. While there have been considerable provisions for the gradual implementation of sustainable practices, time is of the essence: it is simply a luxury that we no longer have. Taking inspiration from our international counterparts, we must work tirelessly to propose a new framework for environmental consciousness in medicine. The health sector has a moral imperative to recognize the synergies that exist between planetary health and human health and identify the ways in which they can minimize environmental harm. The Earth is a gift, and we must make sure to steward it well.


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McLean, M., Gibbs, T., & McKimm, J. (2020). Educating for planetary health and

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WHO Regional Office for Europe (2017). Environmentally sustainable health systems: a

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